Surgical or fracture nail



2,1951 M. F. STEPHENS 2,

SURGICAL OR FRACTURE NAIL Filed May 26, 1949 /8 6 INVENTOR.

Mela/v FSTEPHENS,

BY MW a? ATTORN EYS Patented Jan. 2, 1951 SURGICAL OR FRACTURE NAILMarion F. Stephens, Sullivan, Ind., assignor to The GuidoscopeCorporation, Chicago; 111., a corporation of Illinois Application May26, 1949, Serial No. 95,440

3 Claims.

My invention relates to surgical nails for use in the fixation offractured bones, and particularly to fracture nails used in the healingof fractures of the neck of the femur.

In the past practice of hip-nailing a guiding pin or pilot wire hasusually been inserted in the shaft of the femur to guide the fracturenail as it is driven into a hole drilled in the hard outer portion ofthe femur and extending through the fractured neck and into the head orballlike portion of the hip joint. Such fracture nails which haveusually been flanged pins of generally triangular shape in crosssection, must be positioned nearly in the direct weight-bearing line ofthe joint, and so positioned that they receive the support of the densecorticle bone on both sides of the distal fragment. For the best resultsthe X-ray or fluoroscope must be used to determine the length of and theexact location or position of the nail; and in my Patent No. 2,454,680November 23, 1948 I have disclosed a precision instrument for guidingthe drill and the nail, and also the pilot or guide wire when the latteris used, although the use of the instrument eliminates the necessity forthe use of the guide wire.

In the use of the prior fracture nails, it has been found that in somecases the nail does not properly support and hold the broken fragmentstogether, and has a tendency to change it positions and slide out. It istherefore an object of the present invention to provide an improved nailof substantially T-shape in cross section with its top or headtransversely curved and its depending web portion provided withlongitudinally tapered lugs, so that when the nail is positioned in thefractured bone, its curved top will fit the neck of the femur andproperly support the fractured parts while the lugs on its web ordepending flange will effectively hold the parts together and preventthe nail from sliding out.

Another object of the invention is the provision of a nail of thischaracter which will be extremely strong in both vertical and horizontaldirections considering the size of its parts, so that when the weight ofthe body is placed upon the heads of the femurs when the patient standserect, the fractured portions of the neck will be held in properalignment and effectively supported.

A further object is to provide a fracture nail with which no guide wirewill be needed to direct placement of the nail.

With the above and other objects in view, the

invention resides in the novel features of construction and combinationsand arrangements of parts hereinafter fully described, and illustratedin the accompanying drawings, in which:

Fig. l is a view showing the position of my improved surgical nail inthe fractured neck of a femur,

Fig 2 is a side view of the nail on an enlarged scale,

Fig. 3 is an enlarged bottom view,

Fig. 4 is an enlarged end view looking toward the outer end of the nail,and

Fig. 5 is a detail section on line 5--5 of Fig. 2.

My improved fracture nail comprises an elongated body or stem- |0preferably made of stainless steel although it may be formed from othermaterial which has the required strength and which will not corrode orbe irritatin to the body tissues. It will be made in different lengthsvarying from about 2% to 6 inches. The body is of substantially T-shapein cross section, and when in position in a fractured femur as shown inFig. 1, the cross member II is disposed uppermost and the Web member l2extends downwardly. The top surface of the cross portion or member H istransversely curved, the curve corresponding substantially to theaverage transverse curvature of the hard outer portion of the neck ofthe femur. When a person stands erect the weight of the body is carriedby the heads of the femurs, and with the T-shaped nail positioned in afractured femur as shown in Fig. 1, the curved top portion II will be intension and the web [2 in compression. The nail will thus effectivelysupport the broken portions of the bone. Preferably the entire top orcross portion H is transversely curved as seen in Fig. 4, and itslongitudinal edges l3 are made sharp. These edges as well as the bottomedge M of the vertical web portion 12 may be beveled on either side oron both sides as shown so that said edges are V-shaped. The edges l5 ofthe portions II and [2 at the point or end of the nail which is driveninto the drilled hole in the femur, are V-shaped or sharped tofacilitate the driving operation.

When the nail is driven in place both pieces of the bone will be firmlyfastened together by reason of the shape of the nail and the provisionof tapered lugs [6 provided on at least one side of the web l2. Thesenail anchoring lugs are preferably formed by stamping the web tolaterally offset portions of it, as shown in Fig. 5, and thus formdepressions or cavities I! in the side of the web opposite the lugs. Thelugs are outwardly pointed or tapered in the direction in which the nailis driven and the rear or inner ends of the lugs form verticallydisposed shoulders E8 to effectively hold the nail against sliding outof the femur. During the knitting of the fracture the new bone cells ortissues will fill the cavities and assist in preventing any outwardsliding movement of the nail. Any number of the lugs l6 may be provideddepending upon the length of the nail, but one is preferably located /2of an inch from the pointed or outer end, one is located about A; of aninch from the inner or driving end, and one or more may be atintermediate points depending upon the nail length. If desiredtransverse openings or holes I9 of about of an inch in diameter may beformed ,at irregular intervals in the web I2 between the lugs it topermit of the circulation of blood, etc.

The improved nail has no driving head but at its inner end the fiatextremities 20 of the cross and web portions are formed with roundedcorners 2!, the curve being on a radius of about /8 of an inch. Thatwill prevent the patient from feeling the inner end of the nail which isusually left projecting from the bone about 1% of an inch. At said inneror driven end 28 may be formed an aperture 22 to receive the hooked endof an instrument by means of which the nail maybe pulled out of the boneif such removal is necessary or desirable.

With the improved nail it is not necessary to use a guiding wire or pin,since an adaptor or driver may be slipped on the inner end 28 of thenail and used in the V-gulde of the instrument of my above mentionedpatent.

It is believed the manner of using and the advantage of the device willbe understood from the above detailed description, but it is to be notedthat due to the shape of the nail and its position in a fractured femur,the parts of the latter will be very effectively supported and heldtogether so that there will be no displacement and the nail will notchange its postiion or slide out Excellent results have been obtainedfrom the details disclosed and they are preferably followed, but it willbe understood that within the scope of the invention as claimed,numerous minor changes may be made,

I claim:

1. A fracture nail comprising an elongated body of substantially T-shapein cross section having a transversely curved cross member at its topand 9, depending web provided with longitudinally spaced lugs taperedtoward one end of said body.

2. A surgical nail for the fixation of the fractured neck of a femurcomprising an elongated body of substantially T-shape in cross sectionand of a size to be driven into the soft inner part of a femurnecklongitudinally thereof across a transverse fracture, said T-shapebody having its cross portion disposed uppermost and provided with a topsurface which is transversely curved, the curvature of said top surfacecorresponding substantially to the average transverse curvature of thehard outer portion of the neck of the femur to effectively support thebroken portions of the bone, the web portion of said T-shaped body beingdisposed vertically and projecting downwardly from the longitudinalcenter of said cross portion to prevent relative rotation of the brokenportions of the neck of the femur.

3. A fracture fixation member of metal or other suitable materialcomprising an elongated body of substantially T-shape in cross sectionand of a length to extend across a transverse fracture in a bone tounite the two portions thereof, said T- shape body having its entirecross portion transversely curved throughout its length, the transversecurvature cf said cross portion corresponding substantially to thetransverse curvature of the hard outer portion of a fractured bone, theweb portion of said T-shaped body being flat and straight, said webportion projecting from the longitudinal center of the concave face ofsaid cross portion to prevent relative rotation of the broken portionsof a bone.

MARION F. STEPHENS.

REFERENCES CITED The following references are of record in the file ofthis patent:

UNITED STATES PATENTS Number Name Date 2,235,419 Callahan Mar. 18, 19412,239,088 Ettinger Apr. 22, 1941 2,265,208 Thompson Dec. 9, 1941

